title: Association between red and processed meat intake and mortality among colorectal cancer survivors.
abstract: OBJECTIVE
  Red and processed meat intake is convincingly associated with colorectal cancer (CRC) incidence, but its impact on prognosis after CRC diagnosis is unknown. We examined associations of red and processed meat consumption, self-reported before and after cancer diagnosis, with all-cause and cause-specific mortality among men and women with invasive, nonmetastatic CRC.
  
  
  METHODS
  Participants in the Cancer Prevention Study II Nutrition Cohort reported information on diet and other factors at baseline in 1992-1993, 1999, and 2003. Participants with a verified CRC diagnosis after baseline and up to June 30, 2009, were observed for mortality through December 31, 2010.
  
  
  RESULTS
  Among 2,315 participants diagnosed with CRC, 966 died during follow-up (413 from CRC and 176 from cardiovascular disease [CVD]). In multivariable-adjusted Cox proportional hazards regression models, red and processed meat intake before CRC diagnosis was associated with higher risks of death as a result of all causes (top v bottom quartile, relative risk [RR], 1.29; 95% CI, 1.05 to 1.59; Ptrend = .03) and from CVD (RR, 1.63; 95% CI, 1.00 to 2.67; Ptrend = .08) but not CRC (RR, 1.09; 95% CI, 0.79 to 1.51; Ptrend = 0.54). Although red and processed meat consumption after CRC diagnosis was not associated with mortality, survivors with consistently high (median or higher) intakes before and after diagnosis had a higher risk of CRC-specific mortality (RR, 1.79; 95% CI, 1.11 to 2.89) compared with those with consistently low intakes.
  
  
  CONCLUSIONS
  This study suggests that greater red and processed meat intake before diagnosis is associated with higher risk of death among patients with nonmetastatic CRC.
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA 30303-1002, USA. marji.mccullough@cancer.org
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: McCullough
authors.forename: Susan M
authors.initials: SM
authors.lastname: Gapstur
authors.forename: Roma
authors.initials: R
authors.lastname: Shah
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Jacobs
authors.forename: Peter T
authors.initials: PT
authors.lastname: Campbell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008461:Meat Products / Q000009:adverse effects*; D008875:Middle Aged; D016016:Proportional Hazards Models; D017741:Survivors